Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
166 Cards in this Set
- Front
- Back
|
What are the 3 general functions of blood?
|
Distribution of: Oxygen, nutrients, wastes, and hormones
Regulation of: Temperature, pH, and fluid volume Protection from: Fluid loss (clotting), infection (immunity) |
|
|
What is present in the plasma?
|
Water
Proteins Hormones Nutrients Electrolytes |
|
|
In unclotted whole blood, red blood cells account for how much of the total volume?
|
40-50%
|
|
|
In unclotted whole blood, what types of cells are located in the buffy coat?
|
Leukocytes and thrombocytes
|
|
|
What is the name of the fluid fraction of blood after coagulation?
|
Serum
|
|
|
What type of lymphocytes make antibodies?
|
B-cells (aka plasma cells)
|
|
|
What type of lymphocytes are helper and cytotoxic cells?
|
T-cells
|
|
|
What are the 3 different types of white cells?
|
Lymphocytes, granulocytes, and macrophages
|
|
|
What are the 4 different biochemical roles of plasma proteins?
|
Maintenance of oncotic pressure
Transport Defense reactions Coagulation and fibrinolysis |
|
|
Why do intracellular enzymes and tumor markers sometimes appear in the plasma?
|
As a result of the disease
|
|
|
How much of the blood do plasma proteins make up?
|
They are about 7% of the blood volume. The plasma contains over 300 proteins.
|
|
|
Where is albumin produced?
|
The liver
|
|
|
Which plasma protein accounts for about 50% of the total plasma proteins (and 4 to 5 g/kg of body weight)?
|
Albumin
|
|
|
How long is the half life of albumin?
|
About 20 days
|
|
|
How much albumin is synthesized daily?
|
14 to 15 g daily
|
|
|
Which plasma protein helps maintain blood oncotic pressure?
|
Albumin
|
|
|
What does albumin transport?
|
Fatty acids ("free" fatty acids)
Unconjugated bilirubin Metal ions: Ca2+, Fe2+, and Cu2+ Drugs, thyroid, and steroid hormones |
|
|
What plasma protein is an important free radical scavenger in sepsis? (sulfhydryl groups)
|
Albumin
|
|
|
How is albumin a buffer?
|
Because of its abundance
|
|
|
What are possible causes of hypoalbuminemia?
|
Liver disease
Starvation, malnutrition ( Excess excretion by the kidneys (as in nephrotic syndrome) Sepsis |
|
|
What is hyperalbuminemia typically a sign of?
|
Severe dehydration
|
|
|
What is the name of the forces occuring at the capillaries?
|
Starling's forces
|
|
|
What happens to fluid when capillary hydrostatic pressure is 37 mm Hg, tissue pressure is 1 mm Hg, and oncotic pressure of plasma proteins is 25 mm Hg?
Where does this occur? |
Water leaves the capillary.
Arteriolar capillaries |
|
|
What happens to fluid when the hydrostatic pressure is 17 mm Hg, tissue pressure is 1 mm Hg, and oncotic pressure of plasma proteins is 25 mm Hg?
Where does this occur? |
Fluid moves from the extravascular space back into the blood.
Venous capillaries |
|
|
The main force bringing water back from the tissues is the __________ pressure of plasma proteins.
|
Osmotic
|
|
|
Kwashiorkor is a childhood _____________________.
|
protein malnutrition
|
|
|
In Kwashiorkor, plasma proteins concentration is __________. Therefore, there is a ___________ osmotic pressure of the blood, and fluid is not drawn back to the blood and accumulates in ___________ → _________
|
Decreased
Decreased Interstitial space Edema The distained bellies of famine victims is the result of fluid accumulation in extravascular tissues |
|
|
What does the classic triad of nephrotic syndrome consist of?
|
Hypoalbuminemia
Proteinuria Edema |
|
|
In nephritis, what leads to the leak of albumin?
|
Damage to the glomerular basement membrane
|
|
|
In nephritis, what leads to peripheral (leg) edema and pulmonary edema (breathlessness)?
|
Capillary oncotic pressure is reduced
|
|
|
Increased glomerular damage in nephritis results in loss of ___________: immunoglobulins and complement
|
Large proteins
|
|
|
What plasma protein binds hemoglobin?
How does it affect the hemoglobin? |
Haptoglobin
Inhibits its oxidative activity, prevents losses of iron through kidney, and prevents kidney damage by hemoglobin. |
|
|
What removes the hemoglobin-haptoglobin complex?
|
Reticuloendothelial system
|
|
|
In ______________, haptoglobin level decreases because of abnormal breakdown of _________.
|
Hemolytic anemias
RBCs |
|
|
What plasma protein binds free heme released from hemoglobin?
|
Hemopexin
|
|
|
T/F
Free heme is potentially highly toxic. |
True!
|
|
|
Why is free heme potentially toxic?
|
Because it intercalates into membrane and produces free radicals.
|
|
|
a) The heme-hemopexin complex is taken up by _____ cells.
b) In the ______, the released iron binds to _______ c) Depletion of unsaturated hemopexin is an indicator of ____________________ |
a) Liver
b) Liver, ferritin c) intravascular hemolysis |
|
|
What percent of iron goes to each of the following from transferrin?
a) Hemoglobin/erythropoiesis b) Ferritin (stores iron in liver and heart) c) Other processes |
a) 75%
b) 10-20% c) 5-15% |
|
|
Which plasma protein transports iron in plasma as ferric ions (Fe3+)?
|
Transferrin
|
|
|
Which plasma protein protects agains the toxic effects of free iron?
|
Transferrin
|
|
|
Transferrin is normally 30% saturated with Fe3+.
a) (increased/decreased) saturation is indicative of iron overload. b) (increased/decreased) saturation is indicative of iron deficiency. |
a) increased
b) decreased |
|
|
T/F
Transferrin is decreased in inflammatory states due to excessive formation of transferrin-Fe3+ complexes. |
False!
Transferrin is decreased in inflammatory states due to excessive degradation of transferrin-Fe3+ complexes. |
|
|
What is the name of the globular protein complex with 24 subunits?
|
Ferritin
|
|
|
What is the main intracellular iron storage protein?
|
Ferritin
|
|
|
T/F
Ferritin keeps iron in soluble and nontoxic form. |
True!
|
|
|
What is the name of iron-free ferritin?
|
Apoferritin
|
|
|
What can we use to measure the total amount of iron stored in the body?
|
Ferritin
|
|
|
T/F
Hemosiderin is sometimes found circulating in the blood. |
False!
It is always found within cells (as opposed to circulating in blood) |
|
|
What protein is a complex of ferritin, denatured ferritin and other material?
|
Hemosiderin
|
|
|
Which protein is found in situations following hemorrhages?
|
Hemosiderin
|
|
|
T/F
The iron within hemosiderin is very poorly available to supply iron when needed. |
True!
|
|
|
What color are hemosiderin deposits in the kidney?
|
They show up as brown areas
|
|
|
What are some iron-storage proteins?
|
Ferritin and hemosiderin
|
|
|
T/F
Iron is a necessary, non-toxic substance. |
False!
Iron is necessary, but it is potentially toxic. |
|
|
Do humans have a mechanism to excrete excess iron?
|
No
|
|
|
On what level is the iron content in the body regulated?
|
On the level of absorption
|
|
|
What disease is characterized by defects in proteins regulating iron absorption that have led to iron overload?
|
Hereditary hemochromatosis
|
|
|
In what way can iron overload hinder the immune system?
|
Prone to infections and illness
|
|
|
In what way can the pancreas be affected in iron overload?
|
Diabetic complications
|
|
|
What types of heart problems may occur with iron overload?
|
Angina and poor heart rhythm
|
|
|
What types of liver problems are associated with iron overload?
|
Cirrhosis and cancer
|
|
|
T/F
Depression and infertility (after the age of 40) are associated with iron overload. |
True!
|
|
|
To treat iron overload, how often and how long should therapeutic phlebotomy be performed?
|
Once or twice a week
De-ironing may take from 6 months to 3 years |
|
|
In cases of extreme anemia, how is iron overload treated?
|
Chelation (desferal (desferoxomine) infusion)
|
|
|
After treatment of iron overload, how can normal iron levels be maintained?
|
Low-iron diet
Less extreme phlebotomy or chelation |
|
|
What is the major copper transport protein?
What percentage of plasma copper does it carry? |
Ceruloplasmin
About 90% |
|
|
What protein regulates oxidation-reduction, transport and utilization of iron (oxidation of ferrous form into ferric form)?
|
Ceruloplasmin
|
|
|
When are increased concentrations of ceruloplasmin found?
|
In active liver disease or tissue damage
|
|
|
What disease results in decreased levels of ceruloplasmin?
|
Wilson’s disease
|
|
|
What type of inheritance is Wilson's disease?
|
autosomal recessive
|
|
|
What is the mutation associated with Wilson's disease?
|
There are mutations in the ATPase that is involved in transport of copper into the bile
|
|
|
Where is the mutation in Wilson's disease primarily expressed?
|
In the liver, kidney and placenta
|
|
|
The deficiency in Wilson's disease leads to accumulation of copper in what organ, damaging its tissue?
|
Liver
|
|
|
Wilson's disease presents with low plasma concentrations of ____________ and increased urinary/plasma ___________.
|
Ceruloplasmin, Copper
|
|
|
How common is Wilson's disease and when do the symptoms usually appear?
|
Incidence is about 1 in 30,000. Symptoms usually appear between 10 and 21 years.
|
|
|
What are the major serum thyroid hormone binding proteins?
|
Thyroxine-binding globulin (TBG)
Transthyretin (TTR) transports thyroxine and retinol Albumin (HSA) |
|
|
T/F
Most serum T4 and T3 are present in the bound state. |
True!
|
|
|
From most common to least common, list albumin, TBG and TTR.
|
Albumin>TTR>TBG
Albumin is present at approximately 100-fold the molar concentration of TTR and 2,000-fold that of TBG |
|
|
List albumin, TBG and TTR in order of highest affinity to lowest affinity.
|
TBG>TTR>Albumin
TBG has highest affinity, which is 50-fold higher than that of TTR and 7,000-fold higher that of HSA |
|
|
What percent do the following bind serum T4?
a) TBG b) TTR c) HSA |
a) 75%
b) 20% c) 5% This order is because of their affinity |
|
|
Name the major corticosteroid transport protein produced by the liver.
|
Transcortin
|
|
|
Synthesis of transcortin is regulated by what?
|
Estrogens
|
|
|
What levels increase during pregnancy and decrease during cirrhosis?
|
Plasma transcortin levels
|
|
|
Approximately 75% of the cortisol and other corticosteroids in circulation are bound to what protein?
|
Transcortin
The rest are bound to serum albumin. |
|
|
T/F
Transcortin binds and transports progesterone. |
True!
|
|
|
Sex hormone-binding globulin (SHBG) is mainly produced by what?
What are some other organs that produce SHBG? |
The liver
Other organs that produce SHBG include the brain, uterus, testes, and placenta. |
|
|
What protein binds testosterone and estradiol?
|
SHBG
|
|
|
High SHBG is associated with what?
|
Pregnancy, hyperthyroidism, anorexia nervosa and some cancers
|
|
|
Which do laboratory assays usually use: plasma or serum?
|
Serum
|
|
|
Explain "steady state" in regards to enzyme levels.
|
Healthy individuals contain relatively constant levels of the intracellular
|
|
|
Why do healthy individuals have relatively constant levels of intracellular enzymes?
|
Because of normal tissue turnover
|
|
|
T/F
Enzymes are not specific for specific types of tissues. |
False!
Some enzymes are specific for one or a few tissues |
|
|
What limits diagnostic value of many plasma enzymes?
|
Lack of tissue specificity
|
|
|
Increased levels of tissue-specific _________ in plasma reflect damage of the corresponding tissue(s).
|
Enzymes
|
|
|
If a patient has liver disease, for example, hepatitis or tissue damagae in the liver, kidney and muscle, what enzyme will be elevated?
|
Alanine Aminotransferase (ALT)
(if AST/ALT < 1) |
|
|
If a patient has liver disease or tissue damage to the liver, muscle or RBCs, what enzyme will be elevated?
|
Aspartate Aminotransferase
(AST) |
|
|
A patient with primary biliary cirrhosis will have elevated levels of what enzyme?
|
Alkaline phosphatase
|
|
|
48 hours after a myocardial infarction, what enzyme will be elevated?
|
Troponin I (Tn I)
Creatine Kinase levels would have already gone back to normal by this time |
|
|
What enzyme will be elevated during tissue damage to the liver or muscle and late phase of myocardial infarction?
|
Lactate dehydrogenase
|
|
|
Heart muscle damage is indicated by elevated levels of what?
|
Creatine kinase
CK-MB and CK-MM |
|
|
Elevated levels of what enzyme is a marker for prostate cancer?
|
Prostate acid phosphatase (PAP), prostate-specific antigen (PSA)
|
|
|
What enzyme will be elevated in acute pancreatitis?
|
alpha-Amylase
|
|
|
The highest levels of acid phosphatase are found in ____________ prostate cancer.
|
Metastasized
|
|
|
T/F
Manipulation of the prostate gland through massage or rectal exam before a test will not increase its level. |
False!
Manipulation of the prostate gland through massage or rectal exam before a test may increase its level. |
|
|
The physiological function of which enzyme is thought to be a liquefaction of semen?
|
Prostatic acid phosphatase (PAP)
|
|
|
Where are Prostatic acid phosphatase (PAP) and Prostate-specific antigen (PSA) produced?
|
The prostate
|
|
|
What enzyme is often elevated in the presence of prostate cancer as well as other prostate disorders?
|
Prostate-specific antigen (PSA)
|
|
|
A blood test to measure PSA is considered the most effective test currently available for the early detection of prostate cancer
|
Prostate-specific antigen (PSA)
|
|
|
Elevated plasma levels of alpha-amylase may reflect which conditions?
|
Pancreatitis — because of damage to the cells that produce amylase
Trauma of salivary glands Mumps — due to inflammation of the salivary glands |
|
|
In order to measure alpha-amylase for clinical diagnosis, when should blood be taken?
Why? |
Timing is critical when sampling blood for the test. Blood should be taken soon after a bout of pancreatitis pain.
Otherwise it is excreted rapidly by the kidneys. |
|
|
Where can amylase be measured other than the blood?
|
In other body fluids, including urine and peritoneal fluid
|
|
|
CK isozymes are _________ charged and migrate towards the ________.
|
Negatively, anode
|
|
|
Cardiac troponin levels peak at about _____ day(s) after an acute myocardial infarction and return to normal by about _____ days(s).
|
2, 5
|
|
|
CK-MB levels peak at about _____ day(s) after an acute myocardial infarction and return to normal by about _____ day(s).
|
1, 2
|
|
|
The acute phase response is a set of nonspecific host responses to cytokines released in response to what?
|
tissue injury
infection inflammation Causes functional liver changes: ↑ synthesis of acute phase proteins ↓ albumin synthesis, |
|
|
What functional liver changes does the acute phase response cause?
|
↑ synthesis of acute phase proteins
↓ albumin synthesis, |
|
|
Which protein is a major component of the acute phase response and a marker of inflammation?
|
C-reactive protein (CRP)
|
|
|
When is C-reactive protein produced?
|
Produced in response to bacterial infection, inflammation or injury
|
|
|
What protein mediates the binding of foreign polysaccharides and activation of complement system?
|
C-reactive protein (CRP)
|
|
|
T/F
Positive CRP results also occur during the last half of pregnancy or with the use of birth control pills |
True!
|
|
|
What is the concentration of c-reactive protein in normal plasma?
|
<1 mg/L
|
|
|
Slightly elevated levels of ___________ have been correlated with an increased risk of cardiovascular disease.
What are the risk ranges? (low, average, high) |
CRP
Low risk: <1 mg/L Average risk: 1-3 mg/L High risk: >3 mg/L |
|
|
What protein is a natural inhibitor of proteases produced by the liver, manifold increase upon acute inflammation.
|
Alpha 1-antitrypsin (AAT)
|
|
|
What protein is the most important inhibitor of leukocyte elastase?
|
Alpha 1-antitrypsin (AAT)
|
|
|
AAT is secreted by activated ___________ and _____________.
|
Neutrophils and macrophages
|
|
|
AAT breaks down the a)______________ of E. coli and other Gram-negative bacteria leading to their destruction.
b)_________________ breaks down cytokines, immunoglobulin A and G (IgA, IgG), and cleave a component of the complement system, and a receptor on neutrophils that contributes to a _________ of their ability to kill bacteria by phagocytosis |
a) Outer membrane protein A (OmpA)
b) Bacterial elastase c) decrease |
|
|
Unchecked _________ activity can lead to extensive destruction of connective tissue.
|
elastase
|
|
|
The inherited disorders of AAT synthesis, when concentration is reduced to 10-15 % of normal, can result in what?
What factors can increase this process? |
Respiratory complications such as emphysema or chronic obstructive pulmonary disease (COPD)
The process is increased by air pollution and cigarette smoking. |
|
|
Cigarette smoke can lead to oxidation of a)_____________ of b)____________ and thought to contribute to the development of c)___________.
|
a) Methionine 358
b) α1-antitrypsin c) Emphysema |
|
|
Alpha 1-Antichymotrypsin (ACT) belongs to what family of human plasma proteins?
|
a1-globulin family
|
|
|
Which protein is a specific inhibitor of chymotrypsin and other related serine proteases?
|
Alpha 1-Antichymotrypsin (ACT)
|
|
|
What are the normal levels of Alpha 1-Antichymotrypsin (ACT) in human serum.
|
25-40 mg/dl
|
|
|
Which protein is a major component of the amyloid deposits associated with Alzheimer‘s disease
|
Alpha 1-Antichymotrypsin (ACT)
|
|
|
Elevated serum levels of Alpha 1-Antichymotrypsin (ACT) are found in various inflammatory conditions, such as:
|
Crohn's disease
Ulcerative colitis and burn injuries |
|
|
In normal acute phase response after surgery, serum levels of CRP begin to go back down after about how many days?
|
3 days
|
|
|
If an infection develops after surgery, the CRP levels will continue to rise longer than the normal acute phase response. When will they go down again?
|
After treatment
|
|
|
What shape are antibodies?
|
Y-shaped
|
|
|
When are antibodies produced?
|
In response to foreign substances
|
|
|
How many polypeptide chains are in an antibody?
|
Consists of 4 polypeptide chains
|
|
|
The ends of which 2 identical fragments of antibodies bind to a specific antigen?
|
2 identical fragments (Fab) have ends that bind to specific antigen
|
|
|
Fc region of antibodies binds to specific proteins, modulating what?
|
Immune cell activity
|
|
|
Which immunoglobulin crosses the placenta?
|
IgG
|
|
|
Which immunoglobulin's biological function is long-term immunity?
|
IgG
|
|
|
Which immunoglobulin's biological function is as a secretory antibody, on mucous membranes?
|
IgA
|
|
|
Which immunoglobulin is the first response to an antigen?
|
IgM
|
|
|
Which immunoglobulin's biological function is as a B cells receptor?
|
IgD
|
|
|
Which immunoglobulin is involved with allergies and worm infections?
|
IgE
|
|
|
What is the % of total antibody and average life of the following immunoglobulins?
a) IgG b) IgA c) IgM d) IgD e) IgE |
a) 75-80%, 23 days
b) 7-15%, 6 days c) 5-10%, 5 days d) about 1%, 3 days e) .002%, 2.5 days Remember order with - Gabby And Micah Daydream of Eachother |
|
|
Describe the primary response to an antigen.
|
After the first exposure to an Ag, the immune system produces IgM, leading to a gradual increase in Ab titer.
|
|
|
Describe the secondary response to an antigen.
|
After the second contact with the same Ag, the immune system produces a quicker, stronger response due to Abs production by memory cells.
|
|
|
Multiple myeloma is a type of cancer of what type of cells?
|
Plasma cells (producing antibodies)
|
|
|
Multiple myeloma typically affects men and women after what age?
|
50 years
|
|
|
T/F
There is therapy for multiple myeloma, and its prognosis is generally good. |
False!
Its prognosis, despite therapy, is generally poor |
|
|
What types of treatment are available for multiple myeloma?
|
Treatment may involve chemotherapy and stem cell transplant
|
|
|
Multiple myeloma is part of the broad group of diseases called _________________.
|
Hematological malignancies
|
|
|
In multiple myeloma, bone lesions may affect what bones?
|
Skull, vertebrae, ribs and pelvis.
|
|
|
What may cause renal failure in multiple myeloma?
|
The excess production of light chains and its deposition in renal tubules
|
|
|
How can hypercalcemia be caused by multiple myeloma?
|
The breakdown of bone also leads to release of calcium into the blood.
|
|
|
How can anemia result from multiple myeloma?
|
Anemia results from Inhibition of normal red blood cell production (hematopoiesis).
|
|
|
T/F
Many organs can be affected by multiple myeloma, and the symptoms and signs vary greatly. |
True!
|
|
|
What is the common tetrad of multiple myeloma?
|
CRAB
C = Calcium (elevated) R = Renal failure A = Anemia B = Bone lesions |
|
|
In regards to monoclonal antibodies, what can be formed by fusing a mouse B cell with a myeloma cell?
|
Hybridomas
(single specificity antibodies, that can recognize specific antigen) |
|
|
T/F
Hybridomas can divide indefinitely. |
True!
|
|
|
Monoclonal antibodies produce specific Abs in (small/large) amounts.
|
Large
|
|
|
What can monoclonal antibodies be used for?
|
Used in diagnosis of disease, identification of microbes and therapy
|
